Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that focuses on cognition— your thoughts— and on behaviour— your actions. One way of summing up CBT is to say, “you feel the way you think.” Or as William Shakespeare stated so eloquently in Hamlet… “There is nothing good nor bad but thinking makes it so.” (Hamlet, Act II, Scene ii).

But CBT also examines behaviour, since the way you act is often determined by how you feel. Furthermore, the way you act can have a positive or a negative influence on your feelings. Without necessarily realizing it, you may be acting in ways that actually fuel your bad feelings. The interaction between thoughts, feelings, and behaviours is at the core of CBT.

CBT is the first psychotherapy to concentrate on thought processes and their connection with emotional, behavioral and physiological states and the interaction between thoughts, feelings, and behaviours is at its core. Therapy is based on the concept that changing negative thinking patterns and behaviors can have a powerful effect on a person's emotions. The CBT therapist helps the patient to identify, analyze and change their counter-productive thoughts and behaviors, which helps to alleviate feelings of depression and anxiety.

CBT is centered on the idea that people are capable of making choices about how they interpret events in their lives and that each of us can choose to change our cognitions and effects of our thinking on our emotional well-being. As stated by the ancient Greek philosopher, Epictetus, about AD 50-120… “Men are disturbed not by things, but by the view which they take of them.”

How is Cognitive-Behavioral Therapy different
from other therapies?

Years of clinical research and experience have shown that CBT is an extremely effective form of therapy. It relies on simple yet powerful interventions, not "trendy," unproven techniques. CBT is based on logic and the scientific method, as well as a belief in the power of the individual to make choices; to "take charge" and change negative or unhelpful thoughts, feelings, and actions. It is strongly structured and action-oriented and usually of relatively short duration.

CBT has been demonstrated to be effective both on its own or alongside medications. Combining biofeedback and CBT can be especially powerful in treating chronic health conditions in which the body and mind have become stuck in negative and self-defeating interactive patterns that only aggravate or maintain the problem.

How does Cognitive-Behavioral Therapy work?

Extensive scientific research has shown that changing the way a person thinks and behaves can have a profound effect on their emotional state. CBT utilizes a very directive, action-oriented approach that will help you explore, identify and analyze dysfunctional or unhelpful patterns of thinking and acting. Once these counterproductive patterns are identified, you are instructed in ways to effectively challenge and restructure the beliefs, assumptions, thoughts, and behavior that are holding you back. Your behavior becomes based on rational, reality-based and life enhancing thinking. Negative emotional states such as depression and anxiety are soon alleviated. Self-defeating behavior patterns are identified and eliminated. The CBT therapist provides coaching in the skills and techniques you need to successfully address your problems. These skills can then be practiced independently, reducing the need for ongoing therapy which may otherwise be lengthy and expensive.

A recent study at the Rotman Research Institute at Baycrest Centre in Toronto used fMRI brain imaging technology to compare ex-depressed patients who had responded to CBT to those who responded to antidepressant medications. The study authors concluded that patients who recovered from depression with CBT showed changes in brain functioning (increased activation) in the frontal cortex— areas associated with self-referenced thinking— whereas, those who recovered with drugs showed changes (decreased activity) in the deeper brain structures associated with basic emotions. For depressed patients, CBT helped by increasing the ability of the frontal cortex to regulate the deeper emotional centres of the brain whereas drugs appeared to work more directly in shutting down emotions.

Who can be helped by Cognitive-Behavioral Therapy?

CBT is based on a collaborative relationship between doctor and patient. It is most effective with highly motivated people who are determined to help themselves feel better. CBT has helped many people who are suffering from depression, anxiety, obsessive-compulsive disorder, chronic pain, and other disorders.

CBT has also been shown to be an effective adjunct to medically-supervised weight-loss programs.

How well does CBT work?

Numerous research studies over the last 30 years have concluded that CBT alone is at least as effective in the treatment of mild to moderate depression as medications alone— generally considered about 60% effective.

When combined with medications, CBT greatly reduces the drop-out rate and significantly reduces the likelihood of a return of depression (remission) after treatment ends.

But CBT requires a well-trained therapist, more commitment and time on the part of the patient, and is more expensive than medications in the short-term.

A recent large scale treatment study at Brown University, Rhode Island, studied 681 patients diagnosed with chronic depression. A third of the patients were randomly assigned to receive an antidepressant drug— nefazodone (Serzone)— twice daily. Another third, received an hour-long session of CBT each week for 12 weeks, and the final third received both treatments.

Among those patients who completed the full 12 weeks of treatment, 85% of the combined treatment group obtained a significant reduction in their depression symptoms, compared with 52% in the CBT only group and 55% in the medications only group. A “significant reduction” in symptoms was defined as “greater than 50% improvement.

The term “biofeedback” refers to a type of skills training in which persons learn to increase their ability to control biological responses.

Developing out of psychophysiological (mind-body) laboratory research first carried out in the 1950s and ‘60s, biofeedback involves the use of sophisticated instruments to measure moment to moment change in a person’s quantifiable bodily functions such as blood pressure, heart and breathing rates, skin temperature, sweat gland activity, electrical activity of the muscles (including the heart) and brain, and then conveying this information back to the person in real time. Biofeedback can give you information about your inner self by means of external instruments. It is a means for you to see the mind-body connection at work and allows you to learn control over certain bodily functions that typically occur automatically or without conscious awareness.

There are basically two broad types of biofeedback… “peripheral biofeedback” and “neurofeedback”. Peripheral biofeedback is usually focused on the activity of the autonomic nervous system (ANS) that regulates the function of all the internal organs of the body; whereas neurofeedback focuses on brain activity that controls the central nervous system.

Dr. Mueller is expert in the use of both peripheral biofeedback and neurofeedback techniques to help his clients improve their health and performance by gaining increased awareness and control of their bodily and brain responses to both internal (i.e., thoughts) and external events (i.e., stressors).

How does biofeedback work?

Sophisticated and highly sensitive electronic instruments are commonly used in biofeedback to measure and amplify physiological signals from the body and convert these signals— usually through a computer— to a form that is meaningful to both the therapist and patient and which can be used to show moment-to-moment changes in the biological response.

During biofeedback sessions, the therapist will apply one or more sensors to your body to monitor certain physiological responses (e.g., neck and shoulder muscle tension in the photo to the left) and relay these measurements to a computer for processing and display on the computer screen. For example, muscle tension can be measured by sticking small electrodes onto the skin surface over the muscles that we wish to monitor, or a temperature sensor may be taped to the end of a finger to measure changes in skin temperature, or elastic straps may be placed around your abdomen and chest to measure their rise and fall during breathing. Other specialized sensors can be used to measure changes in your pulse and blood pressure, sweat gland activity, the electrical activity of the brain (EEG or brainwaves), or even changes in the perfusion of oxygenated blood within the cerebral cortex. As you move or relax your body or direct your thoughts in a certain way, the monitored physiological values will change and you will be able to see these changes reflected in the computer display and observe the connection between what you do and think and how your body responds. You will discover how to influence and control body responses that are normally automatic and beneath the level of your conscious awareness. By bringing normally unconscious physiological processes to your awareness, biofeedback allows you to experiment with ways to change bodily processes in a desired direction. For example, what causes your blood pressure to rise and fall? If you recognize that thinking angry thoughts raises your blood pressure and that taking a few slow, deep breaths while thinking of a person, place or thing that you truly appreciate will reduce your blood pressure, you have learned a means of controlling your blood pressure.

Some of the more common biofeedback modalities are:

BVP– Blood volume pulse sensors may be attached to a finger or ear lobe and are used to measure heart rate and pulse and provide BVP amplitude and waveform information. These sensors are most often used in heart rate variability biofeedback.

ECG– Called electrocardiography, small electrodes attached to the surface of the skin on the chest or arms are used to record the electrical activity of the heart and the beat-to-beat interval of the heart rate. ECG measures may be part of HRV biofeedback.

EEG– Called electroencephalography, small electrodes attached to the surface of the scalp record the electrical activity (EEG, or brain waves) produced by neuronal activity of the brain. EEG biofeedback is most commonly used to treat brain-based disorders such as ADHD, OCD, and depression.

EMG– Call electromyography, small electrodes attached to the surface of the skin over the muscles record the electrical activity of the muscles as they contract or relax (i.e., muscle activity or muscle tension). EMG biofeedback is often applied to the treatment of musculoskeletal postural, movement and pain problems.

HEG– Called hemoencephalography, a sensor unit using a strong LED red light together with an infrared source placed on the scalp can record changes in blood perfusion in the cortex of the brain under the sensor. HEG biofeedback is most frequently used in treating attentional problems, depression, and migraine headache.

RESP– Special rubberized bands with stretch receptors are tightened over the abdomin and/or chest to record movement with breathing. These sensors are most often used in training proper breathing patterns as part of anxiety or stress management.

SCR– Attached to the fingers or toes, skin conductance sensors are used to monitor the electrodermal response or moment to moment changes in the skin’s resistance to the passage of a small current. Changes in skin resistance are primarily a function of opening and closed sweat pores in the skin. This type of biofeedback has been variously called skin conductance (SC), skin resistance (SR), or galvanic skin response (GSR) and is commonly used in anxiety and stress management.

TEMP– Small temperature sensors are taped to the skin (usually the fingers or toes) to record changes in skin temperature associated with changes in blood flow to the skin. Temperature biofeedback is commonly used in stress management and the treatment of Rayneud’s Syndrome and migraines.

What health conditions can benefit from biofeedback?

Peripheral biofeedback has been demonstrated especially effective in the treatment of acute and chronic illnesses that are stress-related, anxiety-driven or involve autonomic nervous system dysfunction. More recently, neurofeedback has demonstrated efficacy in the treatment of seizure disorders, alcohol and drug addictions, and attention-deficit disorder in both children and adults. Various forms of neurofeedback are also showing great promise in the treatment of other brain-based disorders such as anxiety, depression, insomnia, and cognitive and motor dysfunction resulting from head injury or stroke.

Some conditions that are treatable or can be improved with biofeedback are…

Anxiety Disorders, including panic and OCD

Asthma

ADHD/Attention-Deficit Disorder

Chronic Obstructive Pulmonary Disease (COPD)

Chronic Pain Disorders

Headaches (both migraine and tension)

High Blood Pressure/Low Blood Pressure

Insomnia

Irregular heart rhythms

Irritable Bowel Syndrome

Knee Pain/Patella Femoral Syndrome

Muscle guarding and bracing

Panic Attacks

Chronically cold hands or Raynaud’s Syndrome

Stress-Related Health Problems

TMJ and chronic jaw tension or bruxism

Traumatic Brain Injury

Stress-Related Health Problems

Biofeedback therapists are professionals-- most often psychologists-- who are trained in biofeedback technologies and their application to human functioning. Many biofeedback practitioners are certified through the Biofeedback Certification International Alliance (BCIA). www.bcia.org

Typically a bachelor's or master's degree in a health care field is required followed by didactic biofeedback education, clinical supervision, and physiology coursework. The BCIA's requirements for certification are quite stringent and include a code of ethics.

Many biofeedback practitioners are also members of such voluntary professional groups as the Association for Applied Psychophysiology and Biofeedback (AAPB). www.aapb.org

Dr. Mueller is an Alberta-registered psychologist and a Diplomate-Fellow of the Biofeedback Certification International Allliance. He is also a member of member of the Association for Applied Psychophysiology and Biofeedback as well as the International Society for Neurofeedback and Research (ISNR).

Electroencephalography (EEG) is the measurement of the electrical activity of the brain cortex from the surface of the scalp. The rhythmic waxing and waning of electrical activity as recorded from the scalp reflects underlying cortical brain activity and is commonly referred to as the EEG or “brainwaves”. Electroencephalographs showing the raw unfiltered EEG signal are called clinical EEGs and are often used in hospital settings by neurologists to evaluate epilepsy or determine if there is serious brain pathology, such as a tumour. In these applications, the raw EEG tracings from multiple recording sites are visually examined by the neurologist for abnormal waveforms or spikes that might be indicative of an underlying brain disorder. The EEG is used only for diagnostic testing in most hospital settings and hospital neurologists are primarily interested in the wave morphology (i.e., shape) of the raw EEG tracings. Certain abnormalities in wave morphology may be indicative of an underlying problem such as a seizure focus in epilepsy or a brain tumour, for example.

QEEG is the acronym for “quantitative electroencephalography” whichis the quantitative or statistical analysis of the digitized EEG data. QEEG is an extension of the more routine visual EEG interpretation or “clinical EEG” done in most hospitals by medical specialists and may assist or even augment our understanding of the raw EEG and complex brain function. QEEG analysis is not generally done by neurologists in most hospitals. In lay terms, QEEG is sometimes called “brain mapping”.

QEEG is a procedure that processes the recorded EEG activity from multiple electrodes placed in specific locations on the scalp (i.e., usually 16 or 19) using a computer and various complex mathematical algorithms (e.g., Fast Fourier Transforms, Wavelet Analysis, LORETA, etc.) The digital data is statistically analyzed and compared with “normative” database reference values in a procedure called “neurometric analysis”. The processed EEG is commonly converted into color maps of brain functioning called “brain maps” that may be more easily viewed and interpreted than tables of statistics.

The QEEG does not assess the structure of the brain, but rather, evaluates the manner in which a particular person’s brain functions. It is not designed to diagnose tumors, epilepsy, or other structural medical conditions, but rather, it is a clinical tool that gives us the ability to view the dynamic changes taking place throughout the brain during processing tasks and assist in determining which areas of the brain are fully engaged and processing efficiently. QEEG is also useful in tracking changes in brain function due to various interventions such as neurofeedback or medication.

The use of advanced techniques such as Independent Component Analysis (ICA) and neuro-imaging techniques such as Low Resolution Electromagnetic Tomography (LORETA) can map the actual sources of the cortical rhythms recorded from the scalp. These advanced approaches are changing our understanding of the dynamics and function of the human brain.

In summary, QEEG has been established as a valid test of brain function. Research also indicates that a highly reliable, precise test can be developed if brain waves of an individual are compared to well-constructed statistical databases (e.g., neurometric analysis). This diagnostic procedure yields: " . . . a level of specificity and sensitivity that is comparable to sonograms, blood tests, MRIs and other diagnostic measures commonly used in clinical practice." [Thatcher, Moore, John, Duffy, et. al.Clinical Electroencephalography, 1999]

EEG neurometric analysis is the process of statistically comparing an individual’s QEEG data to “normative” data for his/her age and gender peers. A number of researchers and institutions have collected QEEG data from sample populations of “normal” individuals as well as from sample populations of persons identified as having certain psychoneurological problems such as ADHD, learning disabilities, traumatic brain injury, dementia, depression, bipolar disorder, anxiety disorders, obsessive-compulsive disorder, schizophrenia, or alcohol and substance abuse. Many of these QEEG databases are commercially available and can be accessed to compare an individual’s recorded EEG to one or more selected sample populations and, thereby, determine to what extent the individual may differ from norms for his/her gender and age as well as the extent to which the individual’s QEEG pattern may be statistically similar to that of some identified diagnostic group.

Comparison of an individual’s QEEG to normative data can be useful in the diagnostic process as well as in the planning of appropriate treatment. Specific QEEG signatures or patterns have been found and validated for a number of different disorders and some databases will permit a statistical pattern analysis of the individual’s QEEG data against a selected sample population and generate a statistical estimate of the extent to which the individual fits the sample population. For example, a depressed patient who has a history of mild head injury may be separately compared to age and gender appropriate samples of depressed as well as head-injured people to determine the extent the patient’s QEEG pattern matches the QEEG signature for depression or head injury. Such an analysis may show that the depression is independent of the head injury or it might show that there clearly is a head injury that may explain the symptoms of depression. Treatment might vary dependent on the outcome of such comparisons.

In the case of diagnosing ADHD, over 30 years of published research has clearly concluded that QEEG can reliably differentiate children with ADHD from those without ADHD or with other learning disorders as well as from others with look-alike disorders. Chabot, et al. (Clinical Encephalography, 1995) found QEEG to be a useful adjunct to behavioural testing and clinical evaluation in the differential diagnosis of children with specific developmental learning disorders and those with ADHD. Neurometric discriminant functions that use combinations of QEEG features have been found to distinguish these two types of developmental disorders from each other and from normal development with accuracy levels between 85 and 95%.

For example, the QEEG brain maps (above) were produced with the NxLink database program (John, Prischep, Easton) and show the eyes-closed QEEG data of a 7 year-old female diagnosed with ADHD as compared to normative QEEG data for her age and gender. The topographs are colour-coded to show deviation from the norm in Z-score units; with very light blue indicating very much less than normal values (-99.9%tile), black indicating normal values (50%tile), and white indicating very much greater than normal values (+99,9%tile).

How is QEEG brain mapping different from other brain imaging techniques?

A number of valuable tests of brain functioning are currently available: eg, Positron Emission Tomography (PET), Single Poton Emission Computerized Tomography (SPECT), Functional Magnetic Resonance Imaging (fMRI), and Magnetic Electroencephalography (MEG). Unfortunately, these tests are very costly and, in some cases, there are risk factors associated with the procedures. For example, consider the PET scan. PET scans measure the metabolic activity of the brain and are good at localizing regions of altered activity within the brain. However, PET scans involve the injection of radioactive isotopes that attach to and label various substances in the blood and are considered unsafe for repeated use over a short time period or with pregnant women and small children. SPECT scans have similar risks.

Importantly, recent studies have concluded that QEEG findings are highly correlated with other types of brain analysis. Moreover, with brain wave analysis, subtle brain dysfunction can be detected that may not be at all discernible with other methods.

It is important to make a clear differentiation between QEEG tests of the brain and other commonly used, and perhaps more familiar, imaging techniques in medicine. For example, x-rays, CAT scans and MRIs are all used to measure brain anatomy, or structure. The QEEG, on the other hand, measures brain physiology, or function.

It is also important to understand that a QEEG is not the same as a "clinical EEG," which is routinely used in medical practice to evaluate epilepsy or to determine if there is serious brain pathology, such as a tumor. By contrast, the QEEG does not assess the structure of the brain, but rather, evaluates the manner in which a particular person’s brain functions. It is not designed to diagnose medical conditions resulting from structural damage or abnormality of the brain.

Why should I get a QEEG assessment?

The report of brain wave analysis is a diagnostic aid that gives your health care practitioner an objective scientific tool for use in assessing your mental health. The QEEG provides detailed information about what is functionally out of balance in your brain, and, in turn, may be causing the symptoms you experience. With this more precise understanding of the underlying physiology of your symptoms, your health care practitioner can make a more confident diagnosis and determination of the most appropriate treatment.

There is an increasing body of evidence that there is a positive treatment impact from the use of QEEG to guide the customization of treatment. One recent retrospective research study compared 3 years of treatment data using a common neurofeedback treatment protocol in a standardized manner to 2 years of treatment data using QEEG-based individually-customized neurofeedback treatment protocols. A gross summarizing of the paper shows a doubling of the conservatively estimated clinical success, from 30% to 60%. Further, the total treatment benefit (both ’some benefit’ and ‘full’ benefit groups added together) increased from the previously commonly reported 75-80% to 90% now receiving perceived benefit (Wright, et al., reported at SSNR, Austin 1998).

The cost effectiveness of doing a QEEG assessment before starting neurofeedback therapy is easily seen if fewer treatment sessions are spent “getting it right” as compared to using only clinical guesswork to select appropriate treatment sites. It only takes a few wasted sessions, not to mention possible adverse reactions from inappropriate site selection, to pay for the increased information provided by a QEEG evaluation.

Neurotherapy is a relatively new term for a broad range of technologies that are used clinically to alter brain functioning. There are basically two broad types of neurotherapies… neurofeedback and neurostimulation. Neurofeedback is a form of biofeedback and, as such, simply feeds back information to the brain on its own functioning. Neurofeedback is a way for the brain to learn about itself and, through its own self-regulation processes change its functioning. Neurostimulation therapies, on the other hand, use electrical, magnetic, light, or sound energy to directly stimulate temporary changes in brain activity. Some examples of different neurotherapies that Dr. Mueller uses in his psychology practice are: Electroencephalographic (EEG) and hemoencephalographic (HEG) neurofeedback and such neurostimulation techniques as Audio-Visual Entrainment (AVE), Cranial Electrostimulation (CES), Transcranial Direct-Current Stimulation (tDCS), and Bio Acoustic Utilization Device (BAUD) therapy. These various neurotherapies are discussed in more detail in the following sections.

Sometimes called EEG Biofeedback or brainwave biofeedback, EEG Neurofeedbackis a noninvasive and painless learning strategy that enables persons to alter their brain waves. It is a self-regulatory treatment to normalize and optimize brain functioning. This form biofeedback uses real-time digital technology to monitor the electrical activity (EEG or brainwaves) of the brain cortex from the surface of the scalp and present this information in a form that enables the individual to perceive moment-to-moment changes in the state of the brain and learn to modify this activity in some desired direction.

The neurotherapist will set conditions to let the patient know when brain activity is moving in the desired direction. For example, the patient may hear a tone or music, or see a bar graph rise or fall, or a video may start or stop, in response to changes in her brainwaves. In the case of a child with an attentional problem, a cartoon video might play when he produces more brainwaves associated with focused attention and stop when brainwaves associated with poor focus appear.

QEEG brain mapping and neurometric comparison to normative databases may reveal significant deviations from normal patterns of brain functioning that may be clinically correlated with presented symptoms or complaints. EEG neurofeedback may then be used to change the abnormal patterns of brain functioning towards the norm with frequent improvement in symptoms. For example, a QEEG finding of excessive amounts of slow “theta” brainwaves in the frontal cortex of a person’s brain while awake and alert may be a sign of problems with attentional focus and reduced executive control over other brain regions. In such a case, EEG neurofeedback focused on training the individual to reduce theta activity and increase somewhat faster low “beta” brainwaves in the frontal lobes may reduce or eliminate problems with poor attention, distractibility, and executive control.

EEG neurofeedback can “exercise” inefficient brain functions to make them more efficient or to correct or improve the anomalies in brain functioning that are responsible for many disorders.

Neurofeedback "…meets the American Academy of Child and Adolescent Psychiatry ‘Clinical Guidelines’ for treatment of ADHD, seizure disorders, anxiety (eg, obsessive-compulsive disorder, generalized anxiety disorder, posttraumatic stress disorder, phobias), depression, reading disabilities, and addictive disorders. This finding suggests that neurofeedback should always be considered as a possible intervention for these disorders by the clinician. Specific recommendations based on the body of empirical evidence currently available suggest that neurofeedback be considered by clinicians and parents as a first line treatment of ADHD when parents prefer not to use medication and as an empirically supported treatment choice when significant side effects or insufficient improvement occurs with medication.” (see Hershberg, et al. (2005). Emerging brain-based interventions for children and adolescents: Overview and clinical perspective. Child and Adolescent Psychiatric Clinics of North America, Vol. 14, pp.1-19)

EEG biofeedback was first used clinically by Dr. Barry Sterman in the early 1970s to successfully treat persons with epilepsy. Dr. Sterman discovered that increasing the amount of 14 Hz activity as recorded from the sensorimotor cortex of the brain had the effect of inhibiting seizure activity. In a similar vein, Dr. Joel Lubar in the late 1970s discovered that many persons with attention deficit disorder show too much brain wave activity in the 6-8 Hz range (NOTE: Hz = Hertz = cycles per second or frequency) from the frontal lobes of the brain and EEG biofeedback could be used to train a shift in brain wave activity to the higher frequencies associated with more focused attention. Through the 1980s and 1990s, numerous well-designed controlled scientific studies have demonstrated the efficacy of EEG biofeedback in the treatment of both seizure disorders and attention deficit disorder.

There is now good scientific evidence from both controlled research and clinical studies as well as long-term follow-up that EEG biofeedback can be an effective treatment for seizure disorders and attention deficit disorder when compared to both common drug treatments and placebo, and that treatment affects are long-lasting. There is also growing scientific and clinical evidence supporting the effectiveness of EEG biofeedback in the treatment of the following conditions: drug addictions, alcoholism, anxiety disorders, PTSD, chronic pain, depression, insomnia, specific learning disabilities, and migraine. There are also increasing numbers of clinical reports suggesting that EEG biofeedback may be useful in ameliorating some of the symptoms and dysfunctions associated with such conditions as brain injury, autistic spectrum disorders, chronic fatigue syndrome, fibromyalgia, and senile dementia.

Treatment with EEG biofeedback is based on the theory that once individuals understand their brain activity and learn to manipulate their own brain waves, they will be able to continue to do so, long after the therapy has ended. Some studies have followed patients for as long as 10 years after being treated with EEG biofeedback and have shown no significant loss of treatment gains.

Currently, there are well over 2000 practitioners in the United States and Canada offering some form of EEG biofeedback or other forms of neurotherapy treatment for one or more of the above listed disorders and tens of thousands of children and adults have been treated over the last 30 years. Dr. Mueller is board-certified in EEG neurofeedback by the Biofeedback Certification International Alliance (BCIA) and is a member of the International Society for Neurofeedback and Research (ISNR) and has been practicing neurotherapy for over 15 years.

Near Infrared Hemoencephalography (nirHEG) is a type of brain imaging technology that indirectly measures neuronal activity of the brain. nirHEG measures changes in relative absorption of red (660 nanometers) and infrared (850 nanometers) light passed through the skull into the brain tissue beneath the HEG sensor. The light passes through the semi-translucent scalp, skull and brain tissue and is reflected back by blood in the tissue. The ratio of red to infrared light scattered back to the HEG sensor is used as a measure of localized blood perfusion and oxygenation.

This means that as the local oxygenation of the blood under the light source and sensor increases in response to neural activation, the signal from the HEG device changes. In this way the nirHEG device can detect local changes in the brain’s activation.

The developer of the nirHEG neurofeedback system, Dr. Herschel Toomin found that there was a very good correlation between his device and fMRI systems, which also relies on changes in blood oxygenation to measure brain metabolism.

fMRI uses very powerful magnetic fields to detect localized changes in the magnetic properties of oxygenated blood versus de-oxygenated blood. Areas of the brain that are more active require more oxygenated blood and this demand for more energy is met by localized increases in blood flow. fMRI reveals relative differences in oxygenated blood perfusion across the brain. fMRI technology is very expensive (over $1000 per hour) compared to nirHEG ($100-$200 per hour) and permits a much higher resolution scan of the entire brain’s functioning and is most commonly used in research settings to determine which areas of the brain are involved in particular tasks. Current nirHEG systems can only detect activity in the brain’s outer layer (about 1.5 cm deep)— the cortex, and are almost exclusively used to train cortical activation through biofeedback.

In nirHEG neurofeedback, the trainee tries to increase the signal from the HEG sensor, which is equivalent to activating the cortical region of the brain under the sensor. A computer display shows the change in cortical activation over the course of time. nirHEG neurofeedback directly trains the brain itself. The trainee quickly gains greater control over the flow of blood and the density of oxygenation at the chosen scalp site. Trainees are usually instructed to concentrate and perform a task that directly relates to the region of the brain being trained— e.g., reading, doing math problems, thinking about themselves, or playing a computer game, etc. Training in the left hemisphere of the brain is enhanced by cognitive challenges; whereas training in the right hemisphere is enhanced by spatial activities. Training in the back of the head over the occipital lobes (visual cortex) is a form of relaxation and is enhanced by visualization exercises. Because it is a learning procedure, nirHEG neurofeedback is non-invasive and safe.

Applications of nirHEG Neurofeedback

nirHEG is still a new neurofeedback modality and the published research on its applications and clinical efficacy is still relatively sparse. EEG neurofeedback and audiovisual entrainment (AVE) neurotherapies have been available for a lot longer and have significantly more published research supporting their use in treating various brain-based disorders and problems. But nirHEG neurofeedback is showing some real promise in the treatment of…

Attention Deficit Disorder

Depression

Migraine

One thing that links these three disorders is the possibility of dysregulation of the prefrontal cortex (PFC) of the brain— the area just above your eyes and behind the forehead. The PFC is a particularly important part of the brain that is most highly evolved in humans and plays a central role in purposeful behavior—making decisions, formulating and carrying out plans and intentions, and maintaining attention and concentration in the face of competing stimuli. It coordinates the brain resources needed to carry out our intentions and evaluate our actions in terms of their success or failure in meeting objectives.

The PFC also plays an important role in emotions and motivation; helping us to keep to a long-term plan by somehow holding in mind the good feelings connected with achieving that goal. As well, the PFC has the ability to inhibit other structures in the brain connected to emotions, allowing you for example to override a fear of water and drowning to learn how to swim. The PFC is especially relevant to social emotions because our ability to imagine what other people might be thinking and feeling depends on the PFC.

Numerous brain scanning studies have shown that activation in the PFC is not optimal in the brains of persons who are depressed or have attention-deficit disorder. Optimizing PFC activity may help increase focused attention and concentration, strengthen control over emotions and impulses, enhance the sense of purpose and self-possession, and increase flexible responding to the demands of a given situation. Among the symptoms of poor executive functioning in the PFC are inattention, poor planning or judgment, slow reaction time, lack of social awareness, and poor impulse and emotional control.

To date, clinical reports of nirHEG neurofeedback have most commonly focused on training the prefrontal cortex of the brain. To a large extent this is because nirHEG does not work very well over parts of the scalp that are covered in hair and, where EEG neurofeedback signals from electrodes placed on the forehead are easily contaminated by electrical noise caused by eye blinks and movement, such small muscle movements do not affect the reliability of the nirHEG signal.

Finally, although the underlying neuropathology of migraine remains unknown, there have been a number of clinical reports describing successful HEG treatment of a few hundred migraine patients to date. It is thought that nirHEG biofeedback over the PFC may strengthen inhibitory control over some part of the brain stem thought to generate migraines.

Is there research to support the use of HEG Neurofeedback?

Research on the HEG device and its use in neurofeedback is still quite limited but has been going on at the University of California in Los Angeles and the Biofeedback Research Institute of Los Angeles by Drs. Herschel and Marjorie Toomin for many years. Additionally, other researchers have studied this technology for the treatment of a number of different brain disorders.

Results have suggested that HEG neurofeedback can enhance cognitive functioning and reduce symptoms associated with hypoperfusion (i.e., reduced cerebral blood flow and oxygenation) in a number of disorders.

Subjects in studies of HEG neurofeedback have not reported any significant or long lasting adverse effects. The most commonly reported side-effect is transient mild headache or fatigue following treatment sessions and lasting no longer than a day or two following. Such unpleasant side-effects appear to be the result of working too hard or too long in a training session.

How long does HEG neurofeedback take?

HEG neurofeedback sessions are typically 30-45 minutes in length and consist of some number of 10-15 minute training trials with a short rest between each trial. While many patients will experience a positive response within the first couple of sessions, successful and longer-lasting reduction of clinical symptoms, especially in chronic conditions, will commonly require 10-20 sessions of training. It is usually best to begin training with anywhere from 2-4 sessions per week for the first few weeks and then reduce the frequency of sessions as symptom improvement is solidified.

EEG entrainment refers to the well-known observation that brain waves tend to follow rhythms or frequencies in approximately the range of 1-30 Hz. That is, the brain will tend to produce an increase in EEG voltage or amplitude at the same frequency at which it is stimulated. For example, listening to a metronome steadily beating at 4 beats per second (a frequency of 4 Hz) will tend to cause an increase in brain wave activity at approximately 4 Hz frequency, whereas listening to a metronome at 10 beats per second (10 Hz) will cause an increase in faster 10 Hz brain waves. Similarly, looking at a light that is flashing at a certain rate or frequency will tend to increase brain wave activity at that same frequency— speed up or slow down the flash rate of the light and the brain waves will tend to follow. This “frequency following” response of the EEG is put to good use in various audio-visual entrainment devices which operate on the assumption that the human brain has a tendency to change its dominant EEG frequency (brain rhythm) towards the frequency of a strong external stimulus. Such an external stimulus is often aural, as in the case of binaural or monaural beats and isochronic tones, or else visual, as in the case of flashing lights, or even electromagnetic radiation, as may be generated by cell phones.

Audio-visual entrainment (AVE) is a subset of brainwave entrainment that uses flashes of light and pulses of tones to guide the brain toward various states of dominant brainwave activity. AVE devices are often called light and sound machines or mind machines and are most frequently used to alter brainwave activity toward a more quiet, relaxed and meditative state. AVE devices are said to induce deep states of relaxation, relaxation, and in some cases, altered states of consciousness that have been compared to those obtained from deep meditation and shamanic exploration.

AVE devices may also help in the treatment of psychological or physiological disorders.

AVE devices typically consist of a control unit, a pair of headphones and/or LED light goggles. The unit controls the sessions and drives the synchronized pulsing sound in the headphones and the flashing LEDs in the goggles. Sessions will typically aim at directing the average brainwave frequency from one level to another (high to lower or low to higher) by ramping up or down in frequency in several steps or sequences. Target frequencies typically correspond to Delta (1-4 Hz), Theta (4-8 Hz), Alpha (8-12 Hz), SMR/low Beta (12-16 Hz) or Beta (13-30 Hz) and can be adjusted by the user based on the desired effects. AVE devices are most commonly used by consumers to reduce stress and anxiety, induce relaxation and enhance sleep or meditation.

AVE devices are sometimes used by clinicians together with peripheral biofeedback or neurofeedback training in the treatment of such problems as anxiety, depressed mood, insomnia, chronic pain, and attention deficit disorder.

Although AVE devices are generally safe and free of significant or lasting adverse effects, rapidly flashing lights may be dangerous for people with photosensitive epilepsy or other seizure disorders. Persons with seizure disorders or a history of seizures should not use AVE devices without medical supervision. AVE may set off headaches in headache-prone individuals or rarely temporary feelings of dizziness or nausea.

Cranial Electrotherapy Stimulation (CES) is another form of neurotherapy and utilizes very low power pulses of electric current induced across a patient’s head via surface electrodes to treat various psychological conditions or neurological symptoms.

Originally developed in the Soviet Union in 1949 as a treatment for sleep disorders, CES was originally known as “electrosleep therapy” and soon became quite common in many European countries. Its original use in treating sleep problems was quickly overshadowed by psychiatric applications for symptoms of anxiety and depressed mood in the years before psychotropic medications became fully ubiquitous in psychiatry.

The treatment of anxiety and depression with CES began in the United States in the early 1960s and it is currently routinely prescribed by thousands physicians and mental health practitioners in the US and Canada for a variety of brain-related psychiatric conditions, although it has yet to achieve full acceptance as a mainstream medical treatment. This lack of recognition within conventional medicine is probably because sufficient information has not been made available to the majority of medical practitioners regarding the safety and efficacy of CES and the pharmaceutical industry spends a great deal of money every year promoting the use of medications instead of such alternative therapies as CES.

CES is widely regarded as safe and is approved in the United States by the Federal Drug Administration (FDA) for the treatment of anxiety, depression, and insomnia.

While there are over 150 published scientific research studies on the use of CES. The overwhelming majority of these studies support the safety and efficacy of CES in the treatment of a number of psychological disorders; particularly anxiety, depression and insomnia. Yet the majority of Canadian physicians in general medical practice are simply unaware of them. Unlike pharmaceuticals, there is no large industry promoting CES to physicians.

While CES is FDA-approved solely for the treatment of anxiety, depression and insomnia, there is scientific data showing promise in the treatment of other conditions such as pain, tension/migraine headaches, fibromyalgia, and substance dependencies (i.e., may reduce symptoms associated with alcohol, drug or tobacco withdrawal), as well as for calming agitated and aggressive patients with neuropsychiatric conditions.

How does CES work?

CES is a relatively simple treatment employing a small, battery-powered device that is similar in size and appearance to transcutaneous electrical nerve stimulators (TENS) devices commonly used in physical therapy for pain relief, but produce very different waveforms at a much lower current level. The CES device sends pulses of very low amperage (i.e., less than 1.0 milliampere) electricity through thin wires attached to electrodes clipped to the ear lobes or attached to the surface of the skin over the bony prominences just to the front of, or behind each ear. The frequency of the electrical pulses can be adjusted— usually from 0.5 Hz to 100 Hz— depending on the treatment effect desired.

CES devices function differently from other biomedical electronics, such as deep brain stimulating electrodes (used to prevent seizures and hand tremors) and heart pacemakers. While those instruments require surgical implantation, CES operates non-invasively. CES is also quite different from electroconvulsive therapy (ECT) or electroshock therapy, a therapeutic modality sometimes used in hospitals to treat severe depression that is not responsive to medication. Where ECT uses a steady, strong electrical current applied directly to the scalp under anesthesia to cause a controlled brain seizure, CES applies a pulsing current that is over a thousand times weaker to the earlobes to induce changes in the excitability and average firing frequency of brain neurons. CES is painless and non-invasive and many CES devices are designed for in-home use.

As with most medications for psychological problems, the actual mechanism by which CES works remains unclear but it is increasingly being viewed as an adaptogen, in that CES reduces stress that underpins many emotional disorders.Research to date suggests a number of possible mechanisms of action, including direct action on the brain at the level of the limbic system, the reticular activating system and the hypothalamus, increased release of various neurotransmitters and endorphins in the brain, increased parasympathetic nervous system dominance, and changes in blood flow and the electrical rhythms (EEG) of the brain. Some researchers have reported rapid increases in serotonin, a brain neurotransmitter associated with relaxation and calmness, and decreases in cortisol, one of the primary stress-related hormones in patients treated with CES. As well, CES is known to increase levels of the brain neurotransmitters norepinephrine and dopamine, both associated with alertness and feelings of pleasure. Interestingly, serotonin, norepinephrine and dopamine are the same neurotransmitters that most antidepressant medications attempt to activate.

CES has also been demonstrated to increase brain electrical patterns known as “alpha rhythms”. Increases in the amount and power of alpha waves in the brain are associated with meditation and increased feelings of relaxation and calm focus.

What does CES feel like?

Applied to the ear lobes or to the mastoid, just behind the ear, CES causes the patient to experience nothing more than a faint tingling sensation. As the treatment continues, most patients begin to feel less anxious, less distressed, and more relaxed and, yet, mentally alert and focused. Patients with positive response to CES generally sleep better and report improved concentration, increased learning abilities, enhanced recall and a heightened state of well-being after one or a series of CES treatments. Most people can resume normal activities immediately after treatment. Some people may experience a euphoric feeling, or a state of deep relaxation that may temporarily and minimally impair their mental and/or physical abilities for the performance of potentially hazardous tasks, such as motor vehicle operation. In some cases, this may last for up to several hours after treatment. Users may do other things during treatment such as read, watch TV, engage in conversation, or work on a computer.

Most patients are left feeling relaxed and alert after a CES session— in what psychologists call an “alpha state”. This state differs from pharmaceutical treatments in that people report feeling that their bodies are lighter and more relaxed and their minds more alert and clear. The results tend to be cumulative and lasting.

What are the adverse effects of CES?

Unlike the United States, where CES devices are sold by prescription only, there are no specific restrictions in Canada on the purchase or home-use of CES devices by the consumer. Canada Health does not recognize CES for the treatment of any medical condition and, therefore, no one selling CES devices can make any direct claims for their effectiveness in treating any medical condition. That said, no one is actually proscribed from using a CES device to treat any condition.

CES has a proven track record of safety, especially in comparison to alternative pharmaceutical treatments for the same conditions. There have been no reports of lasting adverse effects, significant side-effects, or any serious contraindications to CES treatment. CES treatment has not been shown to interact negatively with any medications and may be used adjunctively with psychoactive medications.

That said, labeling of CES devices contains precautions seen on all electromedical devices against use by pregnant women and persons with implanted medical devices such as cardiac pacemakers. Due to the relaxing effect of CES treatment, patients are cautioned in the use of hazardous machinery or driving. Despite the known safety of CES, it is advisable to only use CES to treat clinical conditions under the direction and supervision of a health professional.

More than 25 clinical research studies examining the efficacy of CES for the treatment of depression have been published, with over 80% of these studies reporting significant clinical improvements in the symptoms of depression (Gilula & Kirsch, 2005).

A recent meta-analysis of 22 placebo-controlled CES research studies involving a total of 1075 patients found that the average treatment effect beyond that attributable to placebo was 57% (Gilula & Kirsch, 2005). This compares very favourably with the often claimed 40-60% average treatment effects beyond placebo for antidepressant medications.

The book— Cranial Electrotherapy Stimulation— by Dr. R.B. Smith (2007) reviews the results from over 100 studies involving over 4000 subjects and reports that CES is highly effective in the treatment of insomnia, anxiety, depression, drug abuse, anxiety and cognitive dysfunction with an average of 67% of patients reporting significant improvement in their symptoms.

CES has also been shown to improve sleep and memory consolidation during sleep (Born, et al. 2006; published in Nature).

How is CES treatment actually done?

Although CES devices are relatively inexpensive (generally about $300-$450) and anyone in Canada can purchase their CES device for home use from a local or internet speciality store, it is best to use CES under the advisement or supervision of a qualified health care professional when treating a clinical condition such as an anxiety disorder, depression, insomnia, or chronic pain.

In all cases, the health care professional will need to see you for at least one or two appointments to assess your condition, evaluate your initial response to the CES treatment within the safe and controlled environment of their office, and show you how to properly use the device. In some cases, the health care practitioner will offer a series of regular CES treatments in his/her office; often in conjunction with other treatments such as counselling or psychotherapy. In other cases, the health practitioner may provide you with a CES device for use at home for a period of time or will encourage you to purchase your own device for use at home.

While there certainly may be situations in which it is both practical and sensible to include CES treatments as part of regular clinical visits, in most situations it is far more cost-effective for the patient to use CES on a daily basis at home for a period of time and only see the health practitioner in the clinic for follow-up and any other related treatments.

In the treatment of anxiety or depressed mood, the research has generally shown that 30-60 minutes of CES daily for a period of 2-4 weeks is commonly effective in alleviating symptoms for extended periods of time. However, some patients find that their symptoms will slowly return over the course of time and may benefit from one or more follow-up series of CES treatments. Other patients find that regular use of the CES device for 30-60 minutes a few times a week will effectively maintain treatment gains indefinitely or successfully manage chronic anxiety, depressed mood, insomnia, pain, or stress.

Individual results depend on a variety of factors, including the severity and chronicity of the condition, what medication has been prescribed (if any), the presence of other concurrent medical factors and, ultimately, your level of motivation. Some disorders can be successfully treated in 8-15 sessions; others require more extensive treatment. In the case of more chronic conditions, CES may be required on a regular basis indefinitely to manage symptoms.

It is important to understand that CES may be effective in reducing feelings of anxiety and/or depressed mood, or distress in response to stressors and may benefit sleep but it does not eliminate the psychological or environmental stressors that may be triggering the negative symptoms. In cases where there are underlying psychological, psychosocial or environmental factors triggering or maintaining other forms of therapy, including psychotherapy may be required.

For those patients with more severe acute or chronic conditions there may be extra benefit to combining CES with counselling or psychotherapy as well as other forms of neurotherapy such as Audio Visual Entrainment (AVE) or Transcranial Direct Current Stimulation (tDCS) therapies or certain biofeedback therapies such as Heart Rate Variability (HRV) biofeedback.

Transcranial Direct Current Stimulation (tDCS) is another neurotherapy technique that was originally developed many decades ago and then largely forgotten, has recently as a promising tool to facilitate the treatment of various neuropsychiatric disorders. This new interest is largely in response to the recent growth in the experimental use of Transcranial Magnetic Stimulation (TMS) to treat such neurological and neuropsychiatric conditions as Parkinson’s Disease and chronic depression.

Unlike TMS which focuses powerful pulses of magnetic energy deep into the brain to activate neurons within targeted regions, tDCS applies an electrical current to the scalp that is so low it cannot be felt as it passes through the skull into the brain below. tDCS is a non-invasive, relatively simple and inexpensive method of stimulating the brain and modulating localized neuronal activity using microcurrent derived from a 9-volt battery.

tDCS involves attaching electrodes to your head and allowing a small 1 to 2 milliampere (mA) current to pass through the scalp and into the brain. While this may sound similar to Electroshock or Electro-Convulsive Therapy (ECT), it is actually quite a bit different than that. ECT requires anaesthesia and gives the brain a 1.0 ampere (1000 mA) jolt that causes a seizure and drastically affects the functioning of the entire brain. tDCS, on the other hand, delivers a subthreshold stimulus that only modulates the likelihood that neurons will fire and only influences the area of the brain close to your skull that is directly underneath the electrode. The electrode attached to the (+) anode part of the battery has the ability to enhance neuronal excitability while the electrode attached to the (-) cathode inhibits neuronal excitability. So specific brain areas can either be activated or deactivated in response to stimulation.

While the exact mechanism of action is not yet fully understood, it is thought that tDCS results in polarity-specific shifts of cortical excitability during and after stimulation. Animal experiments have demonstrated that the effect of anodal tDCS is caused by neuronal depolarisation, while cathodal tDCS hyperpolarises cortical neurons. The effects of only 10 minutes of stimulation have been demonstrated to last as long as an hour or more. With longer or repeated stimulation, the effects on neuronal potentiation can become quite long lasting.

How is actually tDCS done?

tDCS neurotherapy may be done in the psychologist’s office while sitting in a comfortable chair and relaxing or talking. The basic treatment consists of a series of five 20-minute sessions over five consecutive days, Monday through Friday. Sometimes a second or even a third series of five treatments may be necessary to obtain maximum improvement in symptoms being treated.

While the patient is seated in a chair, two 5 cm x 5 cm non-metallic conductive rubber electrodes are placed on selected locations of the scalp and covered by saline soaked sponges and held in place by elastic headbands. After the electrodes are properly placed, a tDCS device powered by a 9-volt battery is used to send a steady electrical current of 1-2 mA through the electrodes and into the cortex for 20 minutes.

The electrode attached to the positive (anode) pole of the battery will excite neuronal activity in the cortex under it, whereas the electrode attached to the negative pole (cathode) of the battery will inhibit neuronal activity in the cortex under it.

The procedure does not elicit any pain. Patients receiving tDCS generally report nothing more than a mild tingling or itchy feeling from under the electrode during the stimulation. These sensations usually disappear within a few seconds or a minute after the current is turned on.

Treatment with tDCS is relatively inexpensive, easy to administer, non-invasive, painless, and safe.

What conditions can be treated with tDCS?

Although still limited, the clinical research with tDCS to date suggests that this neurotherapy technique may be safely used to treat a variety of neuropsychiatric conditions including stroke, depression, obsessive-compulsive disorder, migraine, and central and neuropathic chronic pain. tDCS can also relieve the symptoms of narcotic withdrawal and reduce cravings for drugs, including nicotine and alcohol. There is some limited evidence that tDCS can be used to increase frontal lobe functioning and reduce impulsivity and distractibility in persons with attention deficit disorder. tDCS has also been shown to boost verbal and motor skills and improve learning and memory in healthy people.

Is tDCS safe?

tDCS has been shown to be a relatively safe intervention with side-effects limited to focal tingling, itching and at most a local erythema (reddening of the skin) and rarely headaches or feelings of mild dizziness or nausea. Because tDCS neither causes epileptic seizures nor reduces seizure threshold in animals, seizures do not appear to be a risk in healthy individuals. However, this may not be true for persons with epilepsy and tDCS should be used only with extreme caution in such cases. Similarly, tDCS is not advised during pregnancy. Research has shown that current densities below 25 mA/cm2 do not cause any brain tissue damage. Stimulation protocols using a 1-2 Ma current strength applied through electrodes of 15-30 cm2 for periods of 20-30 minutes fall well within safety limits.

Clinical experience with tDCS to date suggests that tDCS is a safe adjunctive therapy to medication and patients do not need to reduce or stop taking their medications while undergoing tDCS.

The BAUD, or Bio Acoustical Utilization Device, is a new and powerful neurotherapy tool for personal change. Invented by Dr. Frank Lawlis, an American pioneer in medical psychology and the Clinic Director of the Lawlis-Peavey Clinic in Dallas, Texas. The BAUD is a hand-held device with a unique technology based on the latest discoveries of neuroscience. By simply listening to special sound frequencies through the BAUD earphones that are common to brain frequencies, you can actually affect the function of neural activity deep within the brain. The BAUD’s intermixed sound frequencies and waveforms help to stimulate natural brain plasticity which results in a powerful shift and release of the energy driving external problems. This same technology has been used in neurofeedback by doctors to treat serious disorders like depression, phobias, substance abuse, OCD, and ADHD.

The Brain: Source of All Problems

There are powerful energies at work in the brain that help drive reactions and compulsions. It has long been known that stress plays a major role in all sorts of problems: overeating, anxiety, depressed mood, anger reactions, and even addictions. Stress will magnify your problem when it pushes you to react to a situation the same way, over and over again. Every time you reach for a snack to calm down, or let yourself dwell on your fears, you actually create and strengthen neural pathways in the brain. These pathways are kind of like ruts in a well-worn road. Once made, you can follow the tracks easily, but it is extremely difficult to pull out of them. So it becomes harder and harder to resist these unwanted urges or reactions. It becomes a vicious circle. Each time you react, the ruts just get deeper. Eventually your brain gets stuck in the “on” and your unwanted habit becomes a constant nagging urge—and seems impossible to get rid of!

Changing these negative feelings or reactions is extremely difficult since the source is often unconscious. You don’t fully understand it; you can only feel it as an intense emotional pressure that expresses as an out-of-control appetite or a mind obsessed with worry. Until the source of this stress is relieved, the neural pathway stays active and the unwanted urge or feeling remains strong.

How Does the BAUD Work?

The BAUD allows you to disrupt unwanted neural patterns. The Baud is designed to emit sound frequencies that are common to brain frequencies. The user simply tunes the BAUD, and these frequencies mix to create a binaural pulses that initially match the brain frequency of the unwanted neural pattern and then interfere with the brain pattern and disrupt it.

The basic BAUD protocol is quite simple and used with every type of problem…

First, you activate your target issue by focusing your attention on it. Try and identify the location or area in your body where you actually feel your problem and allow yourself to fully experience it. For example, your anxiety about driving in busy city traffic and a feeling of nausea in the pit of your stomach. This activates the corresponding areas of the brain involved in this pattern of worrying thoughts, images, emotions, and physical feelings.

Next, you switch the BAUD on and balance the sound in your earphones by turning the right and left Volume control knobs (lower two knobs) on the BAUD until the sound you hear is moderately loud (not deafening) and perfectly equal in both ears so that it seems centred in your head.

Next, you slowly tune the Pitch or Arousal frequency of the BAUD (upper right pitch knob) until you feel the sound connect to either the body location of your problem—or, more importantly with your feelings themselves. Usually you will experience both at once and a noticeable intensification of your target feeling (e.g., anxiety). This is true whether the target feeling is emotional, an impulse or craving, or a physical sensation such as pain.

After you have found the proper Pitch setting, continue to focus on your problem feelings as you slowly turn the upper left Disrupter knob on the BAUD until you reach a place where the sound seems to neutralize or reduce your problem feeling (e.g., anxiety) you are focusing on. This indicates you are affecting the targeted neural areas of the brain. In the same way that may tune-in a radio station, you may turn the Disrupter knob past this point and then go back, to confirm this is the strongest neutralizing point. The BAUD will be effective over a certain frequency range, not just one point, but tuning as precisely as you can will help maximize results.

Lastly, you should continue to try to keep the target problem active by continually bringing it to mind and, therefore, keeping the neural activity going in the targeted brain areas. Try and do this for anywhere from 5 to 20 minutes after you have found the Disrupter frequency that reduces the targeted feeling before turning the BAUD off and ending the session.

The BAUD works most strongly on these active brain areas, and in a short time, there is usually a marked reduction in the problem’s level of intensity. The key to successfully using the BAUD is to awaken and focus on the feeling state that is associated with your problem. This includes both the physical and emotional feelings connected with your problem. A typical BAUD session may last from 15-30 minutes.

Based on results seen to date, it is believed that the BAUD is able to stimulate a parasympathetic response that brings the targeted neural circuits out of an aroused, or hyperactive state. BAUD results appear to be lasting and suggest that unwanted neural patterns are disrupted and reorganized toward a normalization of neural functioning.

Immediately after a session, many people report feeling profound improvement in stress-driven issues that may have plagued them for years, even a lifetime. While individual results will vary, most BAUD users experience a degree of relief from one session that will last anywhere from a few hours to several days or longer.

What problems can the BAUD Treat?

The BAUD is showing itself effective in treating many different emotional and physical symptoms. Dr. Lawlis has used it with nearly a thousand patients over the last three years at the Lawlis-Peavey Clinic to treat a broad range of emotional problems, physical cravings, and pain. Whether treating emotional or physical problems, the BAUD protocol is the same. Some of the problems that have been successfully treated are… appetite control, food cravings, smoking, anxiety, specific fears and phobias, depression, compulsions and obsessions, attentional problems, and pain.

How safe is the BAUD?

The BAUD is cleared and registered with the US Food and Drug Administration. It is recognized as safe, and there have never been any serious negative side effects reported from BAUD use, even with extended use in clinical applications. Although relatively quite rare, the most commonly reported adverse events have included headaches, temporary dizziness and nausea, and experiencing unwanted strong feelings without obtaining any reduction within the session. As well, some individuals who are especially sound sensitive may find the BAUD sound too unpleasant. Finally, some individuals will experience some continued sensitivity to environmental sounds or hear non-existent sounds (e.g., ringing, humming, water running, etc.) for a brief period after using the BAUD.